Helmet use and bicycle-related trauma injury outcomes.

Background: It is essential to identify factors that predict helmet use, so as to mitigate the injury and mortality from bicycle accidents.Objective: To examine the relationship between helmet use and the bicycle-related trauma injury outcomes among bicyclists with head/neck injury in the US.Methods: Data from the 2002-2012 National Trauma Data Bank were used, including all trauma bicycle riders involved in bicycle-related accidents whose primary reason for the hospital or Intensive Care Unit stay was head or neck injury. Using multiple logistic regression, the association between helmet use, Injury severity score (ISS), length of stay in hospital (HLOS) and Intensive Care Unit (ICULOS), and mortality was examined.Results: Of the 76,032 bicyclists with head/neck injury, 22% worn helmets. The lowest was among Blacks, Hispanics, and <17 years old. Wearing a helmet significantly reduces injury severity, HLOS, ICULOS, and mortality (i.e total and in-hospital). Males had a severe injury, longer HLOS, ICULOS, and higher mortality than female. Blacks and Hispanics had longer HLOS and ICULOS and higher total mortality than Whites, but had a similar chance for in-hospital mortality.Conclusions: More effort is needed to enhance helmet use among at-risk bicycle riders, which may reduce injury severity, HLOS, ICULOS, and mortality.

Health Disparities in Patients with Congestive Heart Failure Exacerbations in Los Angeles County.

BACKGROUND: 1.1.Congestive Heart Failure (CHF) is a leading cause of death in the USA, with over 500,000 new cases diagnosed each year. While rates of CHF exacerbation across all races and ethnicities decreased from 2005 to 2009, the number of Black patients with CHF exacerbation who present in Los Angeles (L. A.) County Emergency Departments (ED) remained the highest. We examine disparities in CHF exacerbation rates in L. A. County, and in Los Angeles Service Planning Area (SPA) 6, and compare CHF-related outcomes, and the disposition of these patients post-ED visit. METHODS: 1.2.This is a retrospective analysis using the Office of Statewide Health Planning and Development (OSHPD) Emergency Department, and Ambulatory Surgery Center database from 2005 to 2009. We used the following variables: congestive heart failure, ICD-9 code 428.0, age, gender, race/ethnicity, insurance status, and disposition. Univariate and descriptive statistics identified distributions of the study variables. There were a total of 13,766 in the study population. RESULTS: 1.3.SPA 6 had higher hospitalization rates across all races and ethnicities, compared to L.A. County as a whole. Blacks constitute 9.1% of the County population, but represented 32% of patients diagnosed with CHF in the ED. Only about 10% of L. A. County's population resides in SPA 6, yet over 22% of the entire County's CHF patients reside there. CONCLUSIONS: 1.4.CHF continues to disproportionately affect Black individuals in L.A. County, and younger adults in SPA 6. Our results indicate that residing in this service planning area, in addition to race, can predict greater likelihood of presenting with CHF exacerbation in the ED, and greater likelihood of hospitalization. Future research on the association of CHF exacerbation with different sociodemographic measures among minority, underserved and disadvantaged patients is needed. These can identify and help mitigate inequities and weaknesses in our health care system, which are manifest through stark health disparities among different racial, ethnic and socioeconomic groups.

Profile of Hospital Admissions due to Self-Inflicted Harm in Los Angeles County from 2001 to 2010.

We aimed to describe the demographic profile of self-inflicted harm (SIH) in Los Angeles County between 2001 and 2010 and to investigate trends over this 10-year period. We used the California Hospital Discharge Data to investigate all cases of hospital admission due to SIH, including suicide attempts and if they had a concurrent psychiatric diagnosis based on ICD-9 codes. African-Americans (AA) had the highest 10-year SIH admission rates. SIH admission rates remained steady throughout the 10-year study period. Median age of SIH was significantly lower in Latinos. Episodic mood disorders were the most common psychiatric comorbidity. The use of solid/liquid poisoning was the most common SIH method among all racial/ethnic groups. We found major disparities in SIH admissions across racial/ethnic subgroups. The importance of programs to identify, prevent, and treat SIH in these groups is discussed.

The theory of planned behavior (TPB) and texting while driving behavior in college students.

OBJECTIVE: To examine the role of intent and other theory of planned behavior (TPB) constructs in predicting college students' willingness to text while driving (TWD). METHODS: This was a cross-sectional study. 243 male and female college students enrolled in the 2013-2014 academic year in the College of Health, Human Services & Nursing completed a survey on TWD. INCLUSION CRITERIA: All races and ethnicities, ≥18 years of age, cell phone owner, and licensed driver. RESULTS: Over 70% of the sample (n = 243) reported talking on a cell phone and sending and receiving text messages "at least a few times" while driving within the past week. However, only 27% reported being stopped by police. Of these, 22% reported being fined. Within the past 30 days, 26% reported reading or sending TWD and having to slam on the brakes to avoid hitting another car or pedestrian(s) as a result. In all, 47% of the variance in intention to send TWD was accounted for by the full TPB model. Intention, in turn, predicted willingness to TWD. Intention also mediated the relationship between perceived behavioral control and willingness to TWD. CONCLUSION: Attitude was found to be the strongest predictor of intention. In addition, intention was found to mediate the relationship of willingness to TWD on perceived behavioral control. These findings highlight potential factors that could be targeted in behavioral change interventions seeking to prevent TWD.

Depression Symptoms, Acculturation, Needing Care, and Receiving Care: A Study of Adolescents Living in California.

BACKGROUND: The objectives of this study are 1) to depict the prevalence of moderate depressive symptoms (MDS) in adolescents living in California, 2) to examine the role of acculturation in reported MDS, and 3) to identify any relationship between acculturation, "needing emotional help," and "receiving psychological or emotional counseling," as reported by adolescents with MDS. METHODS: We analyzed data from a cross-sectional population-based telephone survey for adolescents who completed the California Health Interview Survey (CHIS) in 2007, 2009, and 2011-2012. The primary predictor variable was level of acculturation. Outcome variables were 1) the presence of MDS, 2) whether participants needed help with emotional problems, and 3) whether they had received psychological or emotional counseling. RESULTS: Of the sample (n = 9816), 6.0% had MDS; 50% of these reported needing help for emotional problems, and 30% reported receiving psychological/emotional counseling. Multivariate analysis that included the interaction effects of race/ethnicity and acculturation showed that the latter was not associated with any of the outcome variables. However, Latino adolescent with MDS and moderate acculturation were less likely to report needing help for psychological/emotional problems, compared to their White counterparts with higher acculturation. CONCLUSION: Our findings suggest disparities in reporting depression symptoms and receiving psychological/emotional help are not driven by adolescents' acculturation levels. However, more studies are needed to clarify what cultural factors facilitate or inhibit moderately acculturated Latino adolescents from reporting needing help for psychological/emotional problems.

Risk factors associated with different types of intimate partner violence (IPV): an emergency department study.

BACKGROUND: Domestic intimate partner violence (IPV) is a serious health care concern, which may be mitigated by early detection, screening, and intervention. OBJECTIVES: We examine posited predictors in IPV and non-IPV groups, and in four different IPV profiles. Possible factors include 1) alcohol use, 2) drug use, 3) depression, 4) impulsivity, 5) age, and 6) any childhood experience in observing parental violence. We also introduce a new "Five Steps in Screening for IPV" quick reference tool, which may assist emergency physicians in detection and treatment. METHODS: This was a cross-sectional study using survey data from 412 inner-city emergency department patients. Associations were explored using a chi-squared test of independence, independent-samples t-tests, and a one-way analysis of variance. RESULTS: Nearly 16% had experienced IPV. As a group, they were younger, and more depressed and impulsive than the non-IPV group. They were more likely to engage in binge drinking, use drugs, and had more childhood exposure to violence. In the IPV group, 31% were perpetrators, 20% victims, and 49% both victims and perpetrators. The latter group was younger, more impulsive and depressed, used drugs, and was more likely to have observed parental violence as a child. CONCLUSION: Correlates in groups affected by IPV indicate the same general risk factors, which seem to more acutely affect those who are both perpetrators and victims. Alcohol and drug use, depressive symptoms, and childhood exposure to violence may be factors and signs for which emergency physicians should screen in the context of IPV.

Social Media and Mentoring in Biomedical Research Faculty Development.

PURPOSE: To determine how effective and collegial mentoring in biomedical research faculty development may be implemented and facilitated through social media. METHOD: The authors reviewed the literature for objectives, concerns, and limitations of career development for junior research faculty. They tabularized these as developmental goals, and aligned them with relevant social media strengths and capabilities facilitated through traditional and/or peer mentoring. RESULTS: The authors derived a model in which social media is leveraged to achieve developmental goals reflected in independent and shared projects, and in the creation and expansion of support and research networks. CONCLUSIONS: Social media may be successfully leveraged and applied in achieving developmental goals for biomedical research faculty, and potentially for those in other fields and disciplines.

The Immigrant and Hispanic Paradoxes: A Systematic Review of Their Predictions and Effects.

A survey of the literature indicates that reported advantages of the Immigrant and Hispanic Paradox are inconsistent and equivocal. The healthy migrant hypothesis also suggests that current research approaches consider only "healthy" groups. Other methodological concerns include the simple underreporting of deaths, and that commonly used databases may not include all significant attributes and characteristics. We conducted a systematic review, synthesizing and identifying themes not explicitly found in the current literature. We also employ a simple quantitative index to assess the scholarly strength of references. Paradox protection appears uneven and is not generalizable across races, ethnicities, age groups and genders. In addition, acculturation, health behaviors and diet, ethnicity, acculturative stress, adolescence, undocumented and uninsured status, age of arrival in the United States and length of exposure, gender and age appear to be significant in predicting any beneficial effects.

A Review of Programs, Components and Outcomes in Biomedical Research Faculty Development.

BACKGROUND/OBJECTIVE: To review, compare and synthesize current faculty development programs and components. Findings are expected to facilitate research that will increase the competency and competitiveness of less-established biomedical research faculty. METHODS: We reviewed the current literature on research faculty development programs, and report on their type, components, outcomes and limitations. RESULTS: Nineteen articles met inclusion criteria. There were no prospective studies; most were observational and all lacked a control group. Mentoring was the most successful program type, and guided and participatory learning the most successful enabling mechanism, in achieving stated program goals. CONCLUSIONS: Our findings are limited by the small number of current studies, wide variation in implementation, study design, and populations, and the lack of uniform metrics. However, results suggest that future prospective, randomized studies should employ quantitative criteria, and examine individual, human factors that predict "success."